Digital Commons Network^™

From Product Dispensing To Patient Care: The Role Of The Pharmacist In Providing Pharmaceutical Care As Part Of An Integrated Disease Management Approach, Laura T. Pizzi, Jean M. Menz, Geneen R. Graber, Dong-Churl Suh

College of Population Health Faculty Papers

During the past decade, the profession of pharmacy has changed dramatically. The Doctor of Pharmacy degree has replaced the Bachelor of Science degree as the first professional degree offered at most accredited U.S. pharmacy schools. Advanced clinical training is now a mainstay of pharmacy training, and this has enabled pharmacists to contribute to disease management efforts. In addition, technological improvements in prescription processing have afforded pharmacists more time to participate in disease management activities. This paper describes how the role of the pharmacist has changed and reviews the results of programs involving pharmacists as disease management providers in the areas …

Meeting Employees' Information Needs In An Evolving Health Care Marketplace, Lise Rybowski

National Health Policy Forum

This background paper explores the role of information in an evolving health care marketplace. It notes that, in a softening economy, many employers seeking relief from escalating health care expenses shift costs onto employees. Some try to make their retreat more palatable by offering employees both more options for how and where they receive health care and more control over how and where the money is spent. This paper discusses the changes that are likely to occur over the next decade in the ways that people make decisions about health plans and providers, the implications for consumers' information needs, and …

The Importance Of Individualized Pharmaceutical Therapy In The Treatment Of Diabetes Mellitus, David B. Nash, Jennifer B. Koenig, Karen D. Novielli, Renee Liberoni, Miriam Reisman

College of Population Health Faculty Papers

Individualized pharmaceutical care for patients with diabetes is necessary for several reasons. First, diabetes is a highly complex disease caused by the interplay among genetic, physiological, and environmental factors that vary from individual to individual. Second, the profile of patients with diabetes has evolved to include people of all ages and socioeconomic backgrounds, with varying medical histories and health behaviors. Third, diabetes often occurs concurrently with other medical conditions, especially in certain groups, such as the elderly. While the treatment goals for all patients with diabetes are the sameto stabilize and maintain healthy blood glucose levels to prevent serious complicationsthe …

The Disappearing State Surpluses: How Come, How Long, And How Will They Affect Social Service Programs?, Randy Desonia

National Health Policy Forum

This issue brief focuses on the impact of budget shortfalls being experienced by many states after several years of strong revenue growth. It describes the structure and sources of state revenues and spending and the causes of the shortfall. It also summarizes the fiscal trends and federal policies that could result in significant budget shortfalls in the future.

Injury Mortality In Texas And The Lower Rio Grande Valley, 1980-1998, Jan M. H. Risser, Carrie Shapiro, William Spears

Population and Public Health Sciences Faculty Publications

Aims: To compare age-adjusted injury mortality rates between Lower Rio Grande Valley (LRGV) Hispanics, Texas Hispanics and Texas Whites. Methods: Using data from the Texas Department of Health, we examined deaths from injuries including: motor vehicle accidents, homicide, and suicide from 1980 through 1998. Results: Injury deaths are the fourth leading cause of death in Texas. Mortality rates for all-cause injuries among LRGV Hispanics were 25% lower than rates among Texas Whites. Traffic accident mortality were quite similar among the study groups. From 1980, the average mortality from traffic accidents per 100,000 persons was 21.9 among Whites and 27.2 among …

Primary Care Case Management: Lessons For Medicare?, Lisa Sprague

National Health Policy Forum

This issue brief looks at primary care case management (PCCM) as a tool that states have used to manage the delivery of care to their Medicaid populations, an alternative to contracting with commercial managed care plans. (States had found PCCM a flexible means of advancing state policy goals, including quality improvement, disease management, and coverage of special-needs populations.) The issue brief considers provider and beneficiary perspectives on PCCM as well as state agency objectives and accomplishments. Finally, it raises the question of adapting the PCCM model for Medicare.

Patterns Of Recent Alcohol, Tobacco, And Other Drug Use Among Caucasian, Black, And Hispanic Students Attending Racially Homogeneous And Heterogeneous School Districts, Matthew J. Cook, Jane A. Ungemack, Hal Mark

SoM Presentations

No abstract provided.

Emergency Preparedness From A Health Perspective: Preparing For Bioterrorism At The Federal, State, And Local Levels, Robin J. Strongin

National Health Policy Forum

Despite the good intentions prior to and in the aftermath of the terrorist attacks of September 11, 2001, the existence of significant gaps in the country's preparedness became increasingly clear in the weeks that followed. This background paper provides an overview of the state of bioterrorism preparedness at all levels of government, identifying both the gaps and the steps being taken to close them. A series of reference materials, including a suggested reading list and Web site addresses, are listed at the end of the paper.

Psychosocial Stress And Prostate Cancer: A Theoretical Model, Gary L. Ellison, Ann L. Coker, James R. Hebert, Maureen Sanderson, Charmaine D. Royal, Sally P. Weinrich

CRVAW Faculty Journal Articles

African-American men are more likely to develop and die from prostate cancer than are European-American men; yet, factors responsible for the racial disparity in incidence and mortality have not been elucidated. Socioeconomic disadvantage can lead to psychosocial stress and may be linked to negative lifestyle behaviors. Regardless of socioeconomic position, African-American men routinely experience racism-induced stress. We propose a theoretical framework for an association between psychosocial stress and prostate cancer. With the context of history and culture, we further propose that psychosocial stress may partially explain the variable incidence of prostate cancer between these diverse groups. Psychosocial stress may negatively …

The Standardized Fish Bioassay Procedure For Detecting And Culturing Actively Toxic Pfiesteria, Used By Two Reference Laboratories For Atlantic And Gulf Coast States, Joann M. Burkholder, Harold G. Marshall, David W. Seaborn, Nora J. Deamer-Melia

Biological Sciences Faculty Publications

In the absence of purified standards of toxins from Pfiesteria species, appropriately conducted fish bioassays are the "gold standard" that must be used to detect toxic strains of Pfiesteria slop. from natural estuarine water or sediment samples and to culture actively toxic Pfiesteria. In this article, we describe the standardized steps of our fish bioassay as an abbreviated term for a procedure that includes two sets of trials with fish, following the Henle-Koch postulates modified for toxic rather than infectious agents. This procedure was developed in 1991, and has been refined over more than 12 years of experience in …

The Distribution Of Airborne Coal Dust In Soil Profiles Of Norfolk, Va And Its Implication For Arsenic Loading To These Soils, William Joseph Bounds

OES Theses and Dissertations

Norfolk, Virginia is home to the Northern Hemisphere's largest coal terminal the Lamberts Point Docks. The coal loading process of this terminal creates large amounts of coal dust, which subsequently is distributed throughout the local region by atmospheric transport and deposition. While the coal dust itself poses only minor health hazards, certain trace elements within the coal, particularly arsenic, may pose environmental as well as significant health hazards. Within coal, arsenic occurs primarily in the mineral pyrite. As pyrite in the coal dust is subsequently oxidized via exposure to the atmosphere and/or meteoric water, arsenic may be released to the …

Aha/Acc Guidelines For Preventing Heart Attack And Death In Patients With Atherosclerotic Cardiovascular Disease: 2001 Update - A Statement For Healthcare Professionals From The American Heart Association And The American College Of Cardiology, Sidney C. Smith Jr., Steven N. Blair, Robert O. Bonow, Lawrence M. Brass, Manuel D. Cerqueira, Kathleen Dracup, Valentin Fuster, Antonio M. Gotto, Scott M. Grundy, Nancy Houston-Miller, Alice Jacobs, Daniel Jones, Ronald M. Krauss, Lori Mosca, Ira S. Ockene, Richard C. Pasternak, Thomas A. Pearson, Marc A. Pfeffer, Rodman K. Starke, Kathryn A. Taubert

Faculty Publications

No abstract provided.

Health Insurance Family Style: Public Approaches To Reaching The Uninsured, Jennifer Ryan

National Health Policy Forum

This issue brief explores existing and potential opportunities to further expand the availability of health coverage for the uninsured and the underinsured, given downturns in the economy and the resulting state budget shortfalls. It also considers the implications of the Health Insurance Flexibility and Accountability (HIFA) initiative announced in August 2001 by the Centers for Medicare and Medicaid Services. Finally, the issue brief describes legislative options for health care reform being debated in Washington, including tax credit incentives, employer-based coverage subsidies and the potential for additional federal funding for public coverage expansions through Medicaid and the State Children's Health Insurance …

Workplace Pollution: Nuclear Safety, Ethics, And The Exploitation--Avoidance Argument, Kristin Shrader-Frechette

RISK: Health, Safety & Environment (1990-2002)

The author reviews evidence of poor worker health and safety practices in United States Department of Energy nuclear facilities in contending that less protective standards for workplace hazards constitute an environmental injustice not rectified by a hazard pay premium.

Acquired Immuno-Deficiency Syndrome (Aids) And Human Immuno-Deficiency Virus (Hiv) In Nevada – Annual Surveillance Report (1999), Mary Guinan, Nancy Kreher, Drew Mather, Wei Yang

School of Public Health Faculty Research

Background:

Acquired Immuno-Deficiency Syndrome (AIDS) is the most severe manifestation of Human Immunodeficiency Virus (HIV) infection. AIDS was first reported in the world in 1981 by the Centers for Disease Control and Prevention. Statewide surveillance for AIDS was begun in 1982. Because the cause of AIDS was unknown at that time, the surveillance case definition included many opportunistic infections and tumors. Persons with AIDS were noted to have abnormalities in their immune system that left them susceptible to certain infections. As more information became available, the AIDS surveillance case definition was modified.

In 1984, HIV was found to be the …

Review Of Children As Partners In Health: A Critical Review Of The Child-To-Child Approach. Pat Pridmore And David Stephens. Review By Terri Combs-Orme, Terri Combs-Orme

The Journal of Sociology & Social Welfare

Pat Pridmore and David Stephens, Children as Partners in Health: A Critical Review of the Child-to-Child Approach. New York: Zed Books, 2000. $ 59.95 hardcover, $22.50 papercover.

Pain Control In Healthcare Organizations: Developing Effective Disease Management Programs, C. Richard Chapman, Stephen D. Lande, Bill H. Mccarberg, David B. Nash

College of Population Health Faculty Papers

Although medicine possesses the knowledge and technology for preventing or relieving most pain, poor pain control is still widespread. Unrelieved pain causes unnecessary suffering and increases health care expenditures. Among the barriers to improving pain control are poor provider education in pain management, misguided beliefs about the inevitability of pain and the dangers of pain medication, provider resistance to changing practice patterns, and administrative resistance to implementing improvements that incur short-term costs but lead to long-term savings. In short, poor pain relief in America's health care institutions is a system issue, and improvement requires a system-wide change. An effective program …

Intermittent Noise Sampling And Control Strategies In The Hospital Environment, Rosarito M. Guerrero

Theses

Noise in the hospital environment can have negative effects on both patients and hospital staff. Unwanted noise can be disturbing and often annoying thus, interfering with patients' sleep and obstructing work performance of the hospital staff. A research study was conducted in the hospital unit to identify and develop methods of intervention for intermittent noise and their source. Routine staff work activity generated noise levels above EPA hospital noise recommendations. A sound level meter and video camera was used to capture noise between the work-shifts. The video camera captured digital readings generated by the sound level meter which, helped identify …

Mission Possible? Maintaining The Safety Net In Urban And Rural Colorado, Karen Matherlee

National Health Policy Forum

This site visit examined urban safety-net concerns in Denver and rural safety-net issues in three communities in the eastern part of Colorado. The Denver segment featured Denver Health, an integrated health system that provides a continuum of services to diverse vulnerable populations. It explored delivery and financing issues for the system itself and in relation to payers, providers, and consumers (particularly through Community Voices) in its catchment area. The eastern Colorado segment focused on delivery and financing issues in Rocky Ford (community health center/migrant health services concerns), Limon (certified rural health center topics), and Hugo (critical-access hospital matters). The visit …

W-2 In 2001: Wisconsin Works At Welfare Reform, Jennifer Ryan, Randy Desonia

National Health Policy Forum

This site visit took federal participants to Wisconsin, widely regarded as one of the pioneers of welfare reform. This site visit focused on Wisconsin Works (W-2), a statewide effort to reduce the state's welfare caseload and send clients to work. In particular, site visitors examined welfare reform policy, service delivery, and financing issues in Milwaukee, at that time the home of 85 percent of W-2 participants. Site visit participants heard from state officials, private-sector representatives, researchers, and advocates on the structure of W-2, its operating policies, and the effects of program implementation on low-income families. They toured a variety of …

Medicare Coverage: Lessons From The Past, Questions For The Future, Robin J. Strongin

National Health Policy Forum

This paper describes the Medicare coverage process for emerging technologies and the ways it has changed over time. Issues addressed include both the national coverage process and local medical review policies, which account for 90 percent of the coverage determinations. The paper also includes a discussion of the relationship between the coverage process and technology assessment, payment systems and the ongoing debate over coverage criteria and levels of evidence.

Psychosocial Correlates Of Physiologlcal Improvement In Female Cardiac Patients: Improving Effectiveness Of Cardiac Rehabilitation Programs, Linda A. Halvorsen

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to determine the relationship between a set or psychosocial variables and a set of physiological variables for a cohort of female cardiac rehabilitation patients. The independent variable set included initial denial, inlcnwl locus of control, perceived mental health status, and perceived physical health status. Dependent variables included change scores for metabolic equivalents and resting heat rate. The sample consisted of76 women who were enrolled in a Phase II cardiac rehabilitation program. Demographic information including number of completed rehabilitation sessions, age, martial status, and diagnosis was provided. A series of bivariate correlations were conducted to …

Disordered Eating And Its Psychosocial Correlates Among Hispanic Adolescent Females, Annette Santiago

All-Inclusive List of Electronic Theses and Dissertations

This study investigated the incidence of disordered eating and its relationship with acculturation, depression, and body dissatisfaction among Hispanic adolescent females. One hundred and five students enrolled at two midwestem high schools completed a Student Demographic Questionnaire, the Bidimensional Acculturation Scale for Hispanics (Marin & Gamba, 1996), the Beck Depression Inventory (Beck, Steer, & Brown, 1996), the Body Dissatisfaction Subscale of the Eating Disorder Inventory (Gamer, Olmstead, & Polivy, 1983), and the Eating Attitudes Test (Gamer, Olmstead, Bohr, & Garfinkel, 1982). Two null hypotheses were examined. The first investigated the relationship among acculturation, depression, body dissatisfaction, and disordered eating utilizing …

A Model For Hiv/Aids Risk Behaviors Of Students In Armenia, Talin Babikian

Loma Linda University Electronic Theses, Dissertations & Projects

Without a cure in now its third decade, AIDS is a concern for both the medical and social science disciplines. Most at risk for a nationwide AIDS epidemic are developing countries, which often lack the necessary resources and knowledge to minimize the spread of the disease. There are an estimated 1500 HIV cases in Armenia, 81.5% of which occur in the 20-39 age group. Armenia’s current economic and political instability, increase in sexually transmitted infections (STI), prostitution, and injecting drug use, and the alarming incidence rates in neighboring countries amplify its risk for a national epidemic.

The goals of this …

Tractor Driving Among Kentucky Farm Youth: Results From The Farm Family Health And Hazard Surveillance Project, Steven R. Browning, Susan C. Westneat, Raeanne Szeluga

Epidemiology and Environmental Health Faculty Publications

This article documents the extent of children's involvement in tractor operations among a representative sample of Kentucky children living and working on family farms. Specifically, we describe children's exposures to tractor-related work activities, profile their use of the tractor (number of days worked), and assess compliance with generally recommended safety measures, such as using tractors equipped with ROPS (rollover protective structures), avoiding riding as passengers on tractors, and operating tractors on public roadways. Data for this study were collected in 1994 and 1995 as part of the NIOSH-sponsored Farm Family Health and Hazard Surveillance Project (FFHHSP). Despite recognition in the …

Income Support Policy And The U.S. Child Support System, Jane Koppelman

National Health Policy Forum

This paper examines the economic profile of custodial and noncustodial parents and the status of the federal/state child support enforcement system. It discusses the reasons for the historically low rate of child support collection; the prospects for new computerized systems to improve the rates of both paternities established and payments collected; ways the system can sustain funding; and the extent to which child support payments can improve the well-being of low-income families.

Pharmacy Benefit Managers: A Model For Medicare?, Veronica V. Goff

National Health Policy Forum

This issue brief uses large-employer experiences with pharmacy benefit managers (PBMs) to shed light on their potential as Medicare outpatient drug benefit administrators. PBM management techniques are discussed, as well as employer perspectives on PBM strengths and weaknesses and lessons learned. Considerations for Medicare policy are also examined. The brief built on a previous NHPF issue brief entitled The ABCs of PBMs.

Teaching | Learning | Investigating | Discovering | Treating | Healing, Douglas J. Macmaster Jr., Paul C. Brucker

Thomas Jefferson University Administrative Documents and Reports

2001 Annual report of Thomas Jefferson University.

The Kentucky Plan: An Innovative Approach To Professional Doctoral Education In Public Health., Joel M. Lee, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

The Doctor of Public Health (Dr.P.H.) degree is designed to prepare graduates for the highest levels of leadership in public health related careers in both public and private settings. The Kentucky School of Public Health has developed an innovative generalist professional degree program offering an extensive battery of courses based on the body of professional public health knowledge. The degree includes extensive supervised field experience as part of the academic training, linking theory with practice. Issues related to professional degrees, curriculum, accreditation and certification, admission, evaluation, plans for institutional cooperation, and demand are addressed.

The Effects Of Occupational Ultrasonic Noise Exposure On Hearing In Dental Hygienists: A Pilot Study, Jennifer S. Dunning

Dental Hygiene Theses & Dissertations

The purpose of this case-control study was to determine whether long-term ultrasonic noise exposure via the dental office environment is related to dental hygienists' hearing status. Registered dental hygienists (N = 698) who live in the Hampton Roads area were mailed a Dental Hygiene Work History Questionnaireto determine those meeting the inclusion criteria and willing to participate in the study. Consenting subjects were categorized into one of two groups according to ultrasonic scaler usage rate and matched on age. Persons with known hearing loss due to infection, disease, or congenital defect were excluded from the study. The final sample …